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Information black hole on trans men’s health risks

With little known, health centres still putting up barriers

The tiny pool of research about trans men contains serious methodological and definitional errors, rendering the information useless, says an Ontario advisor to the province on gay men’s public health.

Ayden Sheim, a member of an advisory body to the Ontario Gay Men’s HIV Strategy, works on the project that produced Primed and is compiling data about Ontario’s trans men. Primed is a safer sex booklet at the heart of a controversial decision by Ottawa’s Centretown Community Health Centre (CCHC) not to publicly display it.

That booklet (also available online at www.queertransmen.org) is designed to educate transgendered men “and the men who dig them,” according to the book’s tagline.

“It’s common knowledge that there really isn’t any useful research out there,” says Sheim.

“People have put together some zines here and there on sexual health for queer trans men, but nothing that’s gone through any kind of actual research process.”

While Primed doesn’t come to any definite conclusions due to the small number of respondents, Sheim says it is a step in the right direction.

Academic research has yet to answer basic questions about trans men’s sexual health, questions like “Are trans men more likely to contract STIs than the general population?” and “Are queer trans men more at risk than their straight-identified trans peers?” What is known is that, as a group, trans men exhibit other traits that tend to make people vulnerable to hepatitis and HIV: trouble overcoming systemic barriers, social marginalization and low self-esteem.

“It’s really important for trans men to see themselves in sexual material,” says Sheim. “First of all to get information but also to realize that there are actually people out there who are concerned about it and that it is relevant to them. It also educates non-trans men who are potentially or currently dating or sleeping with trans men.”

Ottawa-area trans activist Peter Dunnigan has battled personal demons and says as a queer trans man, the demon’s fangs sink a bit deeper, especially if they are under the influence of drugs or alcohol.

“I think anybody under the influence becomes more vulnerable,” says Dunnigan.

Dunnigan has become one of the leading voices in the fight to have Primed publicly displayed at Ottawa’s CCHC.

“When you are a minority and you want to be needed and loved, sometimes you put your own body on the line for that moment of acceptance and someone knowing you and appreciating you for who you are.”

Rebecca Hammond is a researcher with the Trans Pulse Project (transpulse.ca), a community-based research project that is in the process of doing a province-wide study exploring the health of trans communities.

“A significant part of what we’re doing is looking at self-reported HIV rates as well as exploring some of the more immediate risk factors and broader conditions that can create greater vulnerability for HIV among trans men and women in Ontario,” says Hammond.

Hammond goes on to say that trans people are often erased or misrepresented when sexual health research is conducted. Many researchers omit questions pertaining to gender identity or gender history.

“Everyone is assumed to be single gendered in health research, so in that way there’s just very little information,” says Hammond. “Very often people would have put transgender as a third sex, not distinguishing between a trans woman or a trans man.”

Hammond admits that recently more researchers have become aware of trans folk and are beginning to acknowledge them, yet the types of questions researchers ask still create problems.

“In a men’s sexual health survey, if they do ask about gender identity, the research of interest has nothing to do with sexual health specific to trans men’s bodies,” says Hammond. “Also a lot of those systemic sexual health researchers don’t even know how to ask those questions or access those communities. They don’t involve trans men in the formulation of research questions.”

Trans guys attracted to men may also get the feeling they aren’t involved in the thought process of sexual health clinic workers. The gendered methods in which tests are carried out doesn’t include transgendered individuals.

“You have women’s sexual health and men’s sexual health. With that division of services, there are very different approaches,” says Hammond. “It can be very stigmatizing and embarrassing for trans men to access those kinds of services. They are essentially being outed when they enter a waiting room. Those systemic barriers make it challenging for people to access sexual health services specifically for trans guys.”

And while the research is still being reviewed, it’s apparent that queer trans men deserve the opportunity to access the services guaranteed to the general public. Like gays and lesbians, trans individuals are more susceptible to high risk activity.

“Trans people do have sex,” confirms Hammond. “But we need the information to protect ourselves.”